Anesthesia for emergency separation of omphalopagus conjoined twins.

BACKGROUND AND OBJECTIVES The rate of mortality during the surgical separation of conjoined twins in the neonatal period is 50% and can reach up to 75% if it occurs in emergency situations. The planning of the surgical separation procedure is detailed and involves imaging assessment, evaluation of cross-circulation and even other surgical preparation procedures, such as skin expansion. CASE REPORT Eleven-day-old female omphalopagus conjoined twins underwent emergency surgical separation due to the death of one twin caused by sepsis associated to cardiopathy. The liver was shared by the twins and was separated. The surviving twin died six days later. CONCLUSIONS Surgical separation of conjoined twins in the neonatal period must be avoided due to the patients' organic system immaturity. However, emergency situations such as the one described herein can require the procedure to be carried out.